Intradiscal vacuum phenomenon matches lumbar spine degeneration patterns in an ageing population,European Spine Journal

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Intradiscal vacuum phenomenon matches lumbar spine degeneration patterns in an ageing population
European Spine Journal ( IF 2.6 ) Pub Date : 2024-02-28 , DOI: 10.1007/s00586-024-08174-0
Derek T Cawley ₁ , Andrew Simpkin ₁ , Elizabeth Abrahim ₁ , Thomas Doyle ₁ , Nada Elsheikh ₁ , John Fallon ₁ , Mohammed Habash ₁ , Rou Jiing Phua ₁ , Jaimie Langille ₁ , Elvis Matini ₁ , Conor McNamee ₁ , Fayhaa Mohamed ₁ , Cliona Nic Gabhann ₁ , Ali Noorani ₁ , Jieun Oh ₁ , Padraig O'Reilly ₁ , David O'Sullivan ₁ , Aiden Devitt ₁

Affiliation

Purpose

Intra-Discal Vacuum phenomenon (IDVP) is well-recognised, yet poorly visualised and poorly understood radiological finding in disc degeneration, particularly with regard to its role in spinal alignment. CT analysis of the lumbar spine in an aging population aims to identify patterns associated with IDVP including lumbopelvic morphology and associated spinal diagnoses.

Methods

An analysis was performed of an over-60s population sample of 2020 unrelated abdominal CT scans, without acute spinal presentations. Spinal analysis included sagittal lumbopelvic reconstructions to assess for IDVP and pelvic incidence (PI). Subjects with degenerative pathologies, including previous vertebral fractures, auto-fusion, transitional vertebrae, and listhesis, were also selected out and analysed separately.

Results

The prevalence of lumbar spine IDVP was 50.3% (955/1898) and increased with age (125 exclusions). This increased in severity towards the lumbosacral junction (L1L2 8.3%, L2L3 10.9%, L3L4 11.5%, L4L5 23.9%, and L5S1 46.3%). A lower PI yielded a higher incidence of IDVP, particularly at L5S1 (p < 0.01). A total of 292 patients had IDVP with additional degenerative pathologies, which were more likely to occur at the level of isthmic spondylolisthesis, adjacent to a previous fracture or suprajacent to a lumbosacral transitional vertebra (p < 0.05).

Conclusions

This study identified the prevalence and severity of IDVP in an aging population. Sagittal patterns that influence the pattern of IVDP, such as pelvic incidence and degenerative pathologies, provide novel insights into the function of aging spines.

中文翻译：

椎间盘内真空现象与老龄化人口中的腰椎退变模式相匹配

目的

椎间盘内真空现象 (IDVP) 已被广泛认可，但在椎间盘退变中的影像学发现却很少见，也很少被理解，特别是在其在脊柱排列中的作用方面。对老年人群腰椎进行 CT 分析旨在识别与 IDVP 相关的模式，包括腰盆腔形态和相关脊柱诊断。

方法

对 2020 年不相关腹部 CT 扫描的 60 岁以上人群样本进行了分析，没有急性脊柱表现。脊柱分析包括矢状腰盆腔重建，以评估 IDVP 和骨盆倾斜角 (PI)。患有退行性病变的受试者，包括既往椎骨骨折、自体融合、移行椎骨和滑脱，也被挑选出来并单独分析。

结果

腰椎 IDVP 的患病率为 50.3% (955/1898)，并且随着年龄的增长而增加（125 例排除）。腰骶交界处的严重程度增加（L1L2 8.3%、L2L3 10.9%、L3L4 11.5%、L4L5 23.9% 和 L5S1 46.3%）。 PI 越低，IDVP 的发生率越高，特别是在 L5S1 处 ( p < 0.01)。共有 292 名患者患有 IDVP 并伴有其他退行性病变，这些病变更有可能发生在峡部滑脱水平、邻近既往骨折或腰骶移行椎上方 ( p < 0.05)。